Patients were concerned about cleanliness
Patients have rated a London NHS trust as the worst in the country for the overall level of care.
Ealing Hospital NHS Trust in west London came bottom of 165 trusts, according to the Healthcare Commission.
The commission asked 76,000 patients about cleanliness, quality of food, information on treatment and the use of mixed-sex facilities.
Ealing NHS Trust said it had begun a two year improvement programme which includes weekly patient surveys.
Of particular concerns to patients at Ealing was cleanliness with 25% saying doctors failed to wash their hands after examinations.
They also complained that bathrooms and toilets were dirty.
FIVE WORST RATED TRUSTS
Ealing Hospital NHS Trust
Homerton University Hospital NHS Foundation Trust
Mayday Healthcare NHS Trust
Barking, Havering and Redbridge Hospitals NHS Trust
North Middlesex University Hospital NHS Trust
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Other criticisms included admission delays, mixed-sex wards, help with eating meals and food quality.
Paul Reeves, Ealing's director of nursing who is leading the improvement programme, said: "The national patients' survey is carried out once a year and the results published this week relate to a survey of patients from last August.
"We are now carrying out surveys of patients on our wards every week to gain up-to-date information from them which we can act on quickly.
"So far the main concerns have centred around cleanliness, food, and the quality of communication - both written and verbal.
"We are now drawing up a series of action plans to address these issues and are publicising to our staff and patients what their concerns are and how we are going to do something about them.
Another five London trusts were in the bottom 10 for overall care but The Royal Marsden NHS Foundation Trust was the capital's best, rated fifth in the country.